CAST-5 Planning Guide
CAST-5 Second Edition
October 2005
Prepared by
Karen VanLandeghem, MPH
A Collaborative Initiative of
Association of Maternal and Child Health Programs
Johns Hopkins Women’s and Children’s Health Policy Center
Maternal and Child Health Bureau
Health Resources and Services Administration
U.S. Department of Health and Human Services
Women’s and Children’s Health Policy Center
Page 2
Cite as
VanLandeghem K, Ruderman M, Grason H, Varela F, and Silver G, 2005. CAST-5 Planning
Guide. Washington, DC: Association of Maternal and Child Health Programs; and Baltimore,
MD: Women’s and Children’s Health Policy Center, Johns Hopkins School of Public Health.
CAST-5 Planning Guide is not copyrighted . Readers are free to duplicate and use all or
part of the information contained in this publication. In accordance with accepted publishing standards, the Association of Maternal and Child Health Programs and the Johns Hopkins School of Public Health Women’s and Children’s Health Policy Center request acknowledgment, in print, of any information reproduced in another publication.
The Association of Maternal and Child Health Programs
1220 19th Street, NW, Suite 801
Washington, DC 20036
Tel: 202-775-0436
Fax: 202-775-0061
Internet: http://www.amchp.org
The Women’s and Children’s Health Policy Center
Department of Population and Family Health
Sciences
Johns Hopkins School of Public Health
615 N. Wolfe Street
Baltimore, MD 21205
Tel: 410-502-5450
Fax: 410-502-5831
Internet: http://www.jhsph.ed/wchpc
This second edition of the CAST-5 Planning Guide (formerly called the Facilitators Guide)
was supported under a technical assistance contract from the Maternal and Child Health
Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services.
CAST-5© Planning Guide
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Table of Contents
Overview of the CAST-5 Planning Guide ..................................................................... 4
Section I: Roles of the CAST-5 Decision Maker, Facilitator, and Planner ............... 6
Section II: Planning and Tailoring the CAST-5 Process to Meet State Needs .......10
Section III: Preparing for the CAST-5 Meeting.........................................................16
Section IV: Facilitating the CAST-5 Process.............................................................19
Section V: Assuring Momentum and Measuring Success......................................25
Conclusion ..................................................................................................................26
Acknowledgments ......................................................................................................27
Appendices:
1. Revision of CAST-5 Preliminary Edition ............................................28
2. CAST-5 Resource Colleagues ............................................................30
3. Facilitation Techniques and Tips ......................................................33
4. CAST-5 Implementation Options .......................................................35
5. Samples of State CAST-5 Agendas ...................................................37
6. CAST-5 Meeting Planning Checklist..................................................41
7. Sample Group Leader Tip Sheet .......................................................43
8. Sample Meeting Ground Rules .........................................................46
9. Tips and Trigger Questions for Facilitating the CAST-5 Tools..........47
10. Sample Group Process Tool ..............................................................49
11. Prioritization Methods........................................................................51
12. Sample Action Plan Template ...........................................................53
13. Sample CAST-5 Evaluation Form ......................................................54
CAST-5© Planning Guide
Overview
Page 4
Overview of the CAST-5 Planning Guide
Capacity Assessment for State Title V (CAST-5) is a set of assessment and planning tools
designed to assist state Title V maternal and child health (MCH) programs1 in examining
their organizational capacity to carry out the 10 MCH Essential Services.2 CAST-5 is the
outgrowth of over a decade of work with state Title V programs focused on strengthening
core public health functions and assisting programs in their roles and capacities to assure
the optimal health and well-being of women, children and youth, including those with special needs, and their families. The ultimate goal and end product of CAST-5 is the creation
of an action plan for organizational capacity development.
A Preliminary Edition of CAST-5 was published in early 2001 and a Facilitators Guide prepared to complement the CAST-5 tools, providing practical guidance and resources to plan
and manage the process. The Second Edition of CAST-5—released in February 2004—
prompted revisions of the original Facilitators Guide to correspond to the new edition. The
guidance document was renamed the CAST-5 Planning Guide.3
The Planning Guide is written with the assumption that key state Title V program leaders
(referred to in this guide as “state Title V program decision makers”) have engaged in preliminary discussions to determine that CAST-5 will be used for strategic capacity assessment. Please refer to CAST-5, and the Core Questions section in particular, for further information and important guidance before using this guide.
The CAST-5 Second Edition, the CAST-5 Planning Guide, and many other related resources
are available on the web at www.amchp.org/cast5.
Who should use the CAST-5 Planning Guide?
The Planning Guide is intended for use by the person or persons responsible for planning
for, coordinating, and facilitating the CAST-5 assessment. Other documents available on
the CAST-5 website (www.amchp.org/cast5) serve other functions and may be more useful
for assessment participants who are not involved in the planning or facilitation:
1The
term “state Title V program” is used in this Guide to refer to those organizational units accountable for
activities undertaken with funds provided to the state through Title V of the Social Security Act — the Maternal
and Child Health Services Block Grant. This unit or a number of organizational units often administer related
programs for women, children, youth and families such as the Special Supplemental Food and Nutrition Program for Women, Infants and Children (WIC), family planning, and early intervention.
2Grason,
H and Guyer, B., 1995. Public MCH Program Functions Framework: Essential Public Health Services
to Promote Maternal and Child Health in America. Baltimore, MD: Child and Adolescent Health Policy Center,
the Johns Hopkins University.
3For
more details about the changes in the CAST-5 Second Edition and Planning Guide, see Appendix 1.
CAST-5© Planning Guide
Overview
Page 5
•
For a general overview of CAST-5, see the “CAST-5 Overview.”
•
For detailed instructions on using CAST-5, refer to “Instructions and Guidance.”
•
For guidance on incorporating CAST-5 into other Title V planning and assessment activities, see “CAST-5 and the Title V Program Planning Cycle,” “CAST-5
and the Title V 5-year Needs Assessment,” and “Using CAST-5 to Address Title V
Performance Measures.”
The CAST-5 Planning Guide will be helpful to anyone planning for, coordinating, or facilitating the CAST-5 process, whether internal state Title V program staff person, outside facilitator, or consultant. Certain sections, such as Sections I and II, may be helpful for state Title
V program decision makers to determine the optimal use of a facilitator and whether the
use of an outside facilitator would benefit the CAST-5 process.
How is the CAST-5 Planning Guide organized?
The CAST-5 Planning Guide is organized in the following six key sections:
•
Section I:
Roles of the CAST-5 Decision Maker, Facilitator, and Planner
•
Section II:
Planning and Tailoring the CAST-5 Process to Meet State Needs
•
Section III: Preparing for the CAST-5 Meeting
•
Section IV: Facilitating the CAST-5 Process
•
Section V:
•
Section VI: Appendices
Assuring Momentum and Measuring Success
The appendices include such resources as sample state CAST-5 agendas and action plans,
handouts for adaptation in states, general group process facilitation techniques, and tip
sheets for facilitating the core components of CAST-5.
CAST-5 is a dynamic process that will continue to be informed by states that implement the
tools. Periodically, new information and resources will be posted on the CAST-5 website at
www.amchp.org/cast5.
The CAST-5 PowerPoint presentation, available on the web, provides an excellent
overview of CAST-5 for staff who will be participating in the assessment process.
CAST-5© Planning Guide
Section I
Page 6
Section I: Roles of the CAST-5 Decision Maker, Facilitator, and Planner
Key information in this section :
• Role of the state Title V program decision maker
• The Role of the CAST-5 Facilitator
• Characteristics of an Effective Facilitator
• Questions to Consider Before Choosing a Facilitator
• Tasks of the Planner and Facilitator
Strategic planning and assessment are core components of state Title V program efforts to
set program direction and align activities and resources with state and community needs.
CAST-5 fits within overall strategic planning efforts by helping to answer “What do we
have?” and “What do we need to get the job done?” It assists state Title V programs in determining what organizational, programmatic, and management resources must be developed or enhanced in order to fulfill the program’s goals and objectives.
The Role of the State Title V Program Decision Maker
The state Title V program decision maker plays a key leadership role in the CAST-5 process.
Commonly the state Title V program director or his/her designee, the decision maker creates a vision and sets the overall organizational tone for preparing for and carrying out
CAST-5. They provide essential leadership for not only making the CAST-5 process happen
but ensuring that key staff and other decision makers are actively engaged in the process.
Finally, the decision maker is critical to making sure that the outcome of the CAST-5 process—the action plan for organizational capacity development—is implemented.
The decision maker plays a range of roles in CAST-5 that include the following.
•
Create a vision for use and implementation of CAST-5.
•
Translate the CAST-5 vision for senior state health agency administrators, state
Title V program staff, state agency partners and other key stakeholders.
•
Provide leadership in preparing for and going through the CAST-5 process.
•
Provide ongoing communication regarding the importance of using CAST-5, the
results and outcomes of CAST-5, and next steps to senior state health agency
administrators, staff and key partners.
•
Charge the group and staff with roles during the planning and implementation of
the CAST-5 process, and in carrying out the CAST-5 action plan.
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Section I
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•
Advance the goals of the CAST-5 action plan and where relevant, help connect
and translate those goals to other relevant initiatives within the state Title V program, the state health agency, and/or the state.
•
Determine whether, when and how CAST-5 might be used in future capacity assessment planning processes.
The Title V decision maker can play a key role in setting the tone for the assessment
meetings and eliciting active participation of staff and other agency colleagues. Much
time and energy are needed to make the most of the assessment process. Positive
feedback, encouragement, and appreciation go a long way toward ensuring participants are engaged and contributing throughout the entire process.
The Role of the CAST-5 Facilitator
Because CAST-5 typically involves multiple group discussions, consensus building, and development of an action plan, it is helpful to have a designated facilitator(s) to plan for and
orchestrate the CAST-5 process. It is not necessary to hire an outside consultant for this
purpose; a Title V staff person with a “big picture” perspective, good organizational skills,
flexibility, and preferably experience with strategic planning concepts and techniques may
be the designated facilitator with equal success. It may be helpful to designate a separate
meeting planner or coordinator to assist with meeting logistics, though one person can fulfill both functions.
A facilitator can help lead a group through the assessment process, provide objective insights about use of the CAST-5 tools. Using an external facilitator allows all state Title V program staff to fully participate in discussions. It is critical that the facilitator’s role, work and
time expectations be discussed up-front before moving forward with the planning and assessment process.
CAST-5 facilitator roles may include the following:
• Serve as the contact person and “expert” on CAST-5.
• Assist in planning and developing the CAST-5 process.
• Advise state Title V program decision makers on which senior management, program leaders, staff, and others to include in the process.
• Facilitate CAST-5 meetings.
CAST-5© Planning Guide
Section I
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• Lead discussions that help participants prioritize capacity needs.
• Build consensus in the development of the CAST-5 action plan.
• Assure that CAST-5 participants incorporate ways to measure their success and
keep up momentum toward achieving CAST-5 goals.
Characteristics of an Effective Facilitator
An effective facilitator will:
― Manage the process, not the content of group interaction.
― Be acceptable to all the members of a group.
― Remain neutral during discussions and deliberations.
― Have no decision-making authority.
― Place the needs of the group first.
― Balance input.
― Work to increase group effectiveness in identifying and solving problems, and making decisions.
From Varela F and Chene R. Introduction to Group Facilitation Skills Course Outline, University of
New Mexido, 1999.
It is recommended that a state select a facilitator with at least some general knowledge of
Title V programs and of CAST-5. State Title V programs that have used CAST-5 have selected facilitators from within their program, from outside the state agency, or even from
outside the state. This decision is based entirely on state Title V program preferences and
resources.
The WCHPC and AMCHP have organized a cadre of “CAST-5 Resource Colleagues” who
have been trained to assist states with CAST-5. Some of these individuals are available to
serve as a facilitator while others are available only for long-distance consultation by phone
or e-mail. Specific functions of the Resource Colleague are to be negotiated independently
with each state. A listing of CAST-5 Resource Colleagues and the types of consultation they
offer is in Appendix 1. Finally, a set of general group process facilitation techniques, tips
and other information is in Appendix 2.
Key Questions to Consider Before Choosing a CAST-5 Facilitator:
•
Who on the state Title V program staff, in the state health agency, or state has
the skills to facilitate a strategic planning assessment process?
•
Would this person be an acceptable facilitator to all of those participating in the
CAST-5 process?
CAST-5© Planning Guide
Section I
Page 9
•
Does this individual(s) also need to be part of the CAST-5 assessment team and
if so, would their role as a facilitator keep them from full participation in the assessment process?
•
Would the state Title V program benefit most from a facilitator who is knowledgeable of and/or closely tied to the state’s Title V program or someone who is more
neutral?
•
What are the resources, if any, for bringing in an outside facilitator?
•
What type of facilitator skills-set (e.g., consensus-builder, organizer, mediator)
does the state Title V program most need?
•
Are there any potential conflicts that could surface during the process that a facilitator could assist the group to work through?
•
Are there any other internal or external organizational considerations to be made
before selecting a facilitator?
Tasks of the planner or coordinator
• Obtain meeting space.
• Arrange for meals and refreshments.
• Distribute assessment materials.
• Schedule meeting(s).
Tasks of the facilitator
• Serve as the contact person and
“expert” on CAST-5.
• Hold at least one pre-assessment
meeting to orient assessment participants to CAST-5 and answer questions
related to the assessment logistics
and process.
• Plan the assessment agenda. Identify
sections to be carried out in small
groups if desired.
• Facilitate the assessment process by
introducing sections and tasks, leading discussions or designating other
team members to lead them, and
keeping discussions on track and efficient.
CAST-5© Planning Guide
Section II
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Section II: Planning and Tailoring the CAST-5 Process to Meet State Needs
Key information in this section :
• Understanding a State’s Readiness to use CAST-5
• Understanding the State Title V Program Context and Policy Environment
• Clarifying the Goals and Expected Outcomes
• Structuring the CAST-5 Process
• Identifying Who to Involve in CAST-5
Planning for the CAST-5 process is as important as its actual implementation. Without sufficient planning and forethought, decision makers and the facilitator can risk poor support
for the process, inadequate buy-in to the action plan, and potential frustration of CAST-5
participants. Support for CAST-5 can be gained by making sure that the process is adequately structured to meet state needs, assuring the optimal composition of participants,
and keeping senior administrators updated on relevant progress and supportive of the ensuing process.
Both this section and the CAST-5 Instructions and Guidance document outline factors to
consider when planning for the CAST-5 process. For a detailed comparison of different approaches to structuring the CAST-5 process and the pros and cons of different timeframes,
participants, and components to assess, consult Appendix 3.
Understanding a State’s Readiness to Use CAST-5
CAST-5 can be used at a variety of levels (e.g., Title V program, an individual program area).
Understanding a state’s reasons for wanting to use CAST-5 and the overall level of readiness will aid in planning. Facilitators can gain useful background information and reinforce
a “state readiness check” by reviewing the CAST-5 Core Questions with key state Title V
program decision makers.
CAST-5 Core Questions can aid in planning but should also be
The CAST-5 Core Questions used on-site with participants during the assessment process.
represent the fundamental
level of Title V program functioning. (Further information about the Core Questions is located in CAST-5.) The Core Questions assist states in determining whether their program is
meeting basic operational requirements and provide a context for responses to questions
in the subsequent CAST-5 tools. A review of the Core Questions during initial planning can
provide an important context for tailoring the process to meet state needs. It helps assure
that critical background information is clearly communicated, discussed and considered
between the facilitator and decision makers before moving forward in further planning.
CAST-5© Planning Guide
Section II
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CAST-5 Core Questions
(Please refer to the CAST-5 Core Questions Tool for further information.)
1. Have you established the vision/goals for the MCH population?
2. Given the Title V needs assessment, have you identified the priority health issues and
desired population health outcomes?
3. Have you identified the political, economic, and organizational environments for addressing the priority health issues?
4. What are the macro-level strategic directions for the Title V program in light of the responses to questions 1, 2 and 3 above?
5. Have you identified the programmatic organizational strategies you will use to implement the strategic direction identified in #4 and to achieve the desired population outcomes identified in #2?
6. Have you identified the capacity you need to implement the strategies?
Understanding the State Title V Program Context and Policy Environment
Facilitators are encouraged to review key background documents prior to planning the
CAST-5 process. A documents review is particularly important for facilitators who are not
familiar with a state’s Title V program or political environment for policymaking and program delivery. The following list of documents is not exhaustive; however, they can provide
important background information for planning the CAST-5 process.
Documents and Resources That Can Help Inform CAST-5 Planning:
•
The State Title V MCH Program Block Grant Application and Annual Report, including the Title V Needs Assessment and Title V Performance Measures.
•
Organizational charts for the overall health agency, key health agency divisions,
offices and/or bureaus.
•
Recent key reports relevant to the state Title V program including any other
needs, capacity or performance assessments (e.g., the National Public Health
Performance Standards Program).
•
The state Title V program strategic plan.
•
The state Title V program vision and/or mission statements.
•
The web-sites of the Governor’s Office and state health agency.
CAST-5© Planning Guide
Section II
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Clarifying the CAST-5 Goal and Expected Outcomes
During the planning phase, it is extremely useful for the facilitator and state Title V program
decision makers to discuss the goal and expected outcomes of using CAST-5. What part of
the state Title V Program’s capacity do decision makers want to assess? CAST-5 assessments can vary by depth (e.g., completing all CAST-5 components or just one component),
by program entity (e.g., assessing all programs together or selected program units), or by
process (e.g., using one assessment team or small workgroups). This step helps focus planning and implementation, clarify the expected outcomes for team participants, and establish an important focal point for the development of the action plan. Further guidance on
considerations for planning the assessment process is in CAST-5.
It is recommended that the facilitator and key decision makers develop a timeline for the
expected completion of the full CAST-5 process. A timeline is best developed after the
structure of the process has been determined (see next section).
During the CAST-5 meeting, the facilitator can use a discussion of expected outcomes with
participants as a way to identify team members’ expectations. By reviewing these outcomes throughout the process, the facilitator can also help assure that participants’ expectations are addressed. Also, the facilitator can share key dates and a copy of the timeline
with CAST-5 participants.
Tips for Clarifying the CAST-5 Goal and Expected Outcomes:
•
Hold a discussion about the CAST-5 goal and expected outcomes with the key
state Title V program decision makers involved in the CAST-5 process, early in
the planning process.
•
Develop a timeline for completion of CAST-5.
•
Include a written summary of the goal (and any objectives) in CAST-5 meeting
agendas.
•
Use the goal statement in opening discussions of the first CAST-5 team meeting.
•
Engage participants in a discussion of what results or expected outcomes they
hope the CAST-5 process will help them achieve.
•
Review the purpose and expected outcomes throughout the meeting to help assure that the process is addressing team members’ needs as best as possible.
•
Bring the group back to the CAST-5 purpose and expected outcomes when developing the action plan and putting closure on the process.
CAST-5© Planning Guide
Section II
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Structuring the CAST-5 Process
CAST-5 was designed as a flexible process to meet individual state needs. States can use
CAST-5 to aid in changing roles in direct service delivery and strengthening roles in other
public health essential services, inform long-term strategic planning, orient new MCH staff
and directors, and in other planning activities. States can choose to use the entire set of
CAST-5 instruments or specific tools to assess capacity. Likewise, states can decide
whether to conduct the CAST-5 process all at once (e.g., retreat), through a series of meetings or retreats, over a series of months, or some other combination. Examples of CAST-5
meeting agendas from states that have carried out the process are in Appendix 4.
During the planning phase, the facilitator and key decision makers should consider the
benefits and challenges of using short or longer-term time periods for conducting CAST-5.
Implementing CAST-5 over a short time period (e.g., 3-day retreat) can help assure that momentum, collective knowledge of the process, and discussions are not lost due to time
away from the process. However, because CAST-5 involves intensive discussions and deliberations, CAST-5 team members may fatigue quickly and the group may risk not being able
to complete the full process in the allotted time period. Longer time periods can allow for
further time to conduct CAST-5. However, momentum can be lost and CAST-5 team members’ recollection of
discussions may The nature of the CAST-5 process, whether you are using all of the tools
be affected.
or a subset, can be time consuming. Be sure to factor in enough discussion and process time to the meetings.
Factors to Consider When Planning the Duration and Scope of the CAST-5 Process:
•
What is the goal and expected outcome(s) for the CAST-5 process?
•
What type of CAST-5 assessment will be conducted (e.g., assessment of the entire Title V program or a specific unit; use of the full CAST-5 tool or a specific
component)?
•
Who needs to be involved in the CAST-5 process?
•
What is the overall time availability of CAST-5 team members?
•
What are the resources for full-day or extended period meetings?
•
Are there any external deadlines (e.g., state budget, federal Title V Block Grant
Application) that a completed CAST-5 process or action plan would help inform?
•
How much time will be needed to synthesize information from the various stages
of CAST-5? (For example, many facilitators consolidate SWOT Analyses from discussions of multiple Essential Services in order to highlight overarching themes.)
CAST-5© Planning Guide
Section II
•
Page 14
Given the needs of the state Title V program and type of assessment selected,
how much time should the CAST-5 process take? (For information on the timeframes of other states’ CAST-5 processes, see the report “Five Years of Experience with CAST-5,” available at www.amchp.org/cast5.)
Identifying Who to Involve in CAST-5
The composition of CAST-5 participants is important to assuring a thorough capacity assessment and overall support and “buy-in” to the process and final action plan. There are
two main considerations when determining who to involve in CAST-5:
1. Identification of those senior management, program leaders, staff and others
(referred to in this Guide as the “CAST-5 team”) who should participate in the full
process, and
2. Consideration of the broader group of state health agency administrators and
other individuals whose support for the CAST-5 process is needed, but whose
participation in CAST-5 is not necessary. Some states may choose to include
senior administrators in all or some aspects of the CAST-5 process if this is essential to assuring an effective process and outcome.
Assuring that the right mix of senior management or program leaders and staff
participate in the CAST-5 process and keeping key administrators periodically
updated will help assure buy-in to the overall process and final action plan.
State Title V program decision makers will know best which staff to include as part of the
CAST-5 team and which administrators to include or keep informed. However, CAST-5 facilitators can provide important overall guidance to the team composition by asking key questions.
Key Questions to Consider Before Identifying a CAST-5 Team:
•
Given the type of assessment that the state is conducting, which senior management, program leaders, staff and others should be invited to participate in the
full process? Guidelines for consideration include:
― Individuals who will be affected most directly by any decisions that are
made.
― Individuals who will be included most directly in, or expected to carry out,
CAST-5© Planning Guide
Section II
Page 15
the CAST-5 action plan.
― Individuals whose knowledge and expertise are critical to the assessment
process.
•
Who makes the final decisions and signs off on key strategic decisions for the
state Title V program? In terms of CAST-5 involvement, what is the best use of
their time (e.g., full participation in the process, participation at key points of the
process)?
•
Are there any groups or staff not directly part of the Title V program (e.g., state
Medicaid director, family representatives, community organizations) whose involvement in the CAST-5 team might assure greater buy-in, collaboration, or
other benefits?
•
Given what the state wants to accomplish, what is a manageable team size?
Reminder: For more information about variables to consider in planning for
and structuring the CAST-5 process, see Appendix 3: CAST-5 Implementation
Options.
CAST-5© Planning Guide
Section III
Page 16
Section III. Preparing for the CAST-5 Meeting
Key information in this section :
• Making Arrangements for the CAST-5 Meeting
• Developing the CAST-5 Agenda
• Maximizing the Use of Meeting Time
• Identifying and Training Group Leaders
Making Arrangements for the CAST-5 Meeting
The CAST-5 meeting location is usually dependent on resources and space availability. Ideally, the CAST-5 meeting should be held at a location outside of the state health agency office building. This will help minimize CAST-5 team members’ distractions from their day-today work. It will also provide more of a retreat-like setting in which to foster team members’
discussions, group meetings, and “thinking outside the box.” Incorporating provisions for
meals and refreshments in the CAST-5 meeting is also desirable. A meeting planning and
logistics checklist can be found in Appendix 5.
Developing the CAST-5 Agenda
Whether the CAST-5 process is held over several days or an extended time period, there
are important items to consider when developing the agenda. It is recommended that the
meeting agenda and materials be distributed to the CAST-5 team at least one week in advance of the meeting. This will allow sufficient time for participants to review the agenda
and materials.
Tips for Developing a CAST-5 Agenda
•
Develop a narrative agenda and an agenda-at-a-glance. The narrative agenda
can be used with the facilitator and other CAST-5 leaders; the agenda-at-aglance can be used with all participants.
•
Allow for sufficient breaks during the meeting. CAST-5 can be an intense process
for participants and the facilitator.
•
Consider using small work groups for at least some of the CAST-5 Tools.
•
Set time limits for work groups to focus discussions and promote closure.
•
Include a “fun factor” (e.g., use a fun “icebreaker,” encourage work groups to
present their information in creative ways).
•
Factor in time to complete the CAST-5 evaluation and feedback forms .
CAST-5© Planning Guide
Section III
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Maximizing the Use of Meeting Time
Pre-meetings—either face-to-face or via conference call if participants are located in different settings—can help make maximum use of the CAST-5 meeting. They can provide an important venue for orienting participants to CAST-5 and discussing the process and logistics.
While some participants might still need a brief review of CAST-5 at the beginning of the
main meeting, a pre-meeting can help assure that meeting time is primarily devoted to the
assessment process. An overview presentation of the process is available on the CAST-5
website.
Providing participants or work groups with “homework” is also another way to maximize
CAST-5 meeting time. Participants might be asked to review and individually complete the
set of CAST-5 Core Questions prior to coming to the CAST-5 meeting. Work groups might be
asked to conduct portions or all of the Capacity Assessment outside of meeting time and
report back to the full CAST-5 team at a follow-up meeting.
Creating Meeting Packets
The CAST-5 process involves the use of multiple materials and tools. Therefore, it can be
extremely helpful both to the facilitator and participants when packet materials are accessible and simplified.
Tips for Simplifying CAST-5 Packet Contents:
•
Color-code the packet contents, especially CAST-5 forms.
•
Provide work group participants only with those forms that correspond to the
MCH Essential Service(s) their work group is assessing (rather than a full set of
all forms). This can help minimize confusion.
•
Group similar packet contents (e.g., CAST-5 tools) together.
•
Don’t overwhelm participants with too much paper! Provide only the main essentials.
Identifying and Training Group Leaders
Use of small work groups can be an effective way to engage a large group in assessing
some or all of the MCH Essential Services. Especially with larger groups of participants,
work groups can help ensure that CAST-5 team members have more opportunities to speak
and engage in deliberations. When work groups are used, group leaders are an important
supplement and support to the facilitator. However, it is very important that group leaders
are sufficiently prepared before they facilitate a work group.
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Section III
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Group leaders are commonly selected from the pool of CAST-5 team members. State Title V
program decision makers will have the best knowledge of which staff can best lead small
group discussions while still being able to participate in key discussions.
Characteristics of Effective CAST-5 Group Leaders:
• In addition to possessing many of the facilitation skills outlined in Section I, group
leaders should be able to:
• Effectively lead their colleagues in group discussions.
• Use facilitation techniques to assure that all participants have an opportunity to
speak.
• Forego their own personal opinions and biases when individual group members
are discussing key points but also contribute their thoughts and ideas to the assessment process.
• Keep their group on time and on task.
• If there is any work that needs to be accomplished outside of the main CAST-5
meeting, assure that their group fully completes its assignment(s).
It is strongly recommended that the facilitator hold some type of pre-meeting or training
with staff who are selected to be group leaders. The meeting does not need to be lengthy
or extensive. However, it should provide group leaders with an overview of the CAST-5 process, a summary of the respective roles of the group leaders, and an opportunity to ask
questions. A sample “tip sheet” for group leaders is included in Appendix 6 .
Items to Cover During a Group Leader Pre-Meeting or Training:
•
A general overview of CAST-5, particularly those parts of the assessment process
that group leaders will be asked to facilitate.
•
The specific roles and responsibilities of group leaders.
•
The characteristics of effective facilitators.
•
Instructions for what to do with summary worksheets, newsprint or other notes
taken by the group.
•
If work group meetings will be held outside of the main CAST-5 meeting, general
instructions for conducting these meetings, information on who to contact if
questions should arise, and timelines for completion of work.
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Section IV
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Section IV. Facilitating the CAST-5 Process
Key information in this section :
• Conducting the CAST-5 Meeting
• The CAST-5 Process
• Using the CAST-5 Tools and Worksheets
• Building and Reaching Consensus
• Prioritizing Capacity Needs
• Creating a Capacity Development Action Plan
Conducting the CAST-5 Meeting
As with most meetings, establishing and communicating “ground rules” for the CAST-5
process can be extremely helpful in promoting CAST-5 team members’ full and productive
participation. Effective ground rules can help create a climate of trust and open communication between participants. Ground rules should be clearly communicated at the beginning of the meeting and should detail the facilitator’s expectations for group participation.
There are many ways to establish and present ground rules. Facilitators may wish to present a pre-established list, ask participants to brainstorm a list of ground rules important to
them or add items to the pre-established list, or use some other method. Sample lists of
CAST-5 ground rules are in Appendix 7.
Throughout the CAST-5 process, participants may need to be reminded periodically of
which component they are completing and how it fits within the overall assessment. Doing
so will help focus participants’ discussions and work and may help prevent work groups
from getting mired in too much detail.
Tips for Conducting a CAST-5 Meeting
• Identify a note taker to help record the discussions throughout the day.
• Be flexible with time slots and the overall agenda. Some sections of CAST-5 may
take more or less time to complete than originally anticipated.
• Keep the group moving through the process, but keep flexibility in the agenda.
• Periodically remind participants which stage of the process they are conducting.
• Conduct periodic “check-ins” with the full group to ascertain their understanding
of the process and determine if there are any questions.
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• If work groups are used, roam from group-to-group to see whether participants or
group leaders have questions.
• Start the meeting(s) on time and end on time.
The CAST-5 Process
The CAST-5 schematic provides an excellent visual aid of the overall process for participants. The facilitator may wish to post the schematic on a flip chart for easy reference
throughout the meeting.
Review of the CAST-5 Assessment Steps
1. Be sure your assessment team has answered the Core Questions and has that information available for reference.
2. Review the Ten MCH Essential Services with team members to ensure that everyone
shares a common understanding of them.
3. For each Essential Service, discuss each Process Indicator and determine a response
category. Discuss and record strengths, weaknesses, opportunities, and threats (SWOT)
related to performance of each Essential Service.
4. Review and identify the status of listed Capacity Needs.
5. It may be useful to summarize the SWOT analyses across Essential Services for reference in subsequent steps.
6. Discuss strategic issues (e.g., mission, overarching program goals, barriers, opportunities, etc.) and program context related to prioritizing Capacity Needs, drawing on the
SWOT analysis and Core Questions.
7. Prioritize Capacity Needs.
8. Complete, or specify a process for generating, a detailed Capacity Development Action
Plan.
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Section IV
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Using the CAST-5 Tools and Worksheets
Detailed instructions for using each component are included in CAST-5 and are not repeated in this Guide. Facilitators should review and familiarize themselves with the instructions for each section of CAST-5 prior to the meeting. In addition, prior to beginning each
section, and during deliberations as needed, facilitators should remind the CAST-5 team of
both the basic instructions and the general goal or end product of the day. Tips and trigger
questions for facilitating each component of CAST-5 (i.e., Core Questions, Process Indicators, and Capacity Assessment) are included in Appendix 8.
Managing the Information
A lot of information is produced as groups work through the CAST-5 tools. Providing summary information as you move from one portion of the process to the next will help participants keep track of the cumulative results and stay focused on the big picture. At a minimum, build in time to review highlights of each step before moving on to the next. Ideally,
handouts of the completed day’s work would be distributed at the beginning of the next
day’s meeting. Similarly, when small groups work concurrently, their results should be
shared. Although it can be time consuming to create, a consolidation of the SWOT analyses
is extremely helpful in identifying broad themes and areas of overlap across the Essential
Services.
Building and Reaching Consensus
CAST-5 is a series of discussions and assessment steps whereby the CAST-5 team rates
the state’s adequacy in performing specific functions and the capacity to carry out those
functions. At times, reaching team consensus may be difficult. Team members may have
different perceptions and opinions on particular aspects of program functioning. Some
MCH program areas may be better at particular functions than others and may have different capacities. Dissenting views can be recorded in the appropriate sections of the SWOT
analysis worksheets and in the meeting proceedings or notes.
It is the facilitator’s role to help work groups and the CAST-5 team identify areas of strength
and minimal capacity while teasing out and distilling common themes across the Essential
Services. If team members are having a particularly difficult time reaching consensus on a
response category, remind participants that one of the greatest benefits of CAST-5 is the
discussions that the process elicits; the response category chosen is less important. This is
an opportunity to focus on areas in which the Title V program excels as well as where there
are deficiencies.
Tips for Building and Reaching Consensus
•
Remind participants that discussions and deliberations are as important and
CAST-5© Planning Guide
Section IV
Page 22
beneficial as the Process Indicator and Capacity Needs ratings. All discussions
are recorded and used in subsequent steps, resulting in broad “needs themes”
that will become apparent across the Essential Services.
•
If work groups or the CAST-5 team are having trouble reaching consensus, suggest that they take a vote. Differing opinions can be recorded in the appropriate
sections of the SWOT Analysis worksheets and the general meeting notes.
•
Create worksheets or mechanisms that work groups and the facilitator can use
to elicit points of consensus and points of dispute. (The Iowa CAST-5 Listening
Guide, located in Appendix 9, is an example of one state’s effort to assure that
all participant viewpoints were considered.)
•
When prioritizing Capacity Needs, make sure that any points of consensus and
dispute are captured in the summary and specified for each priority area.
Prioritizing Capacity Needs
The Capacity Needs prioritization process is one of the most fundamental components of
the CAST-5 process, as it forms the basis for developing the CAST-5 Action Plan. The facilitator’s role is to review common themes and strategic issues from previous assessment
steps, lead the group through the prioritization process, and assure that a manageable
“short list” of Capacity Needs list is developed to serve as the basis for action planning.
Facilitators can use various group process techniques to assist CAST-5 participants in selecting and prioritizing Capacity Needs. Some states have specified criteria to consider in
determining priorities; examples follow:
Example 1
Example 2
•
A strategic issue whereby if action is
not taken, the problem or opportunity
is likely to encumber the state Title V
program with unbearable future
costs.
•
Acceptability of the potential solution
•
Potential for broad impact—what can
improve multiple arenas
•
Within scope of control
•
Progress is possible within one year.
•
Extensiveness of the problem
•
The area is within the state Title V
program’s control.
•
Political implications
•
Is there a known solution
CAST-5© Planning Guide
Section IV
Page 23
A common mechanism for prioritizing a list of items is the “colored dot” method. There are
several variations to this method which are further described in Appendix 10. The overall
steps are highlighted below.
Overview of the Colored Dot Method for Prioritizing Capacity Needs:
•
Write the summarized list of Capacity Needs by domain on newsprint.
•
Provide participants with 3-5 colored dots.
•
Instruct participants to vote for their top Capacity Needs by placing a colored dot
next to the item on the newsprint. (Facilitators should specify whether participants can use multiple dots for a single Capacity Need.)
•
Identify the Capacity Needs with the most votes and list those on separate newsprint.
•
If the list of Capacity Needs is very lengthy, facilitators may wish to have participants vote twice. In this case, participants’ first set of votes could be for those
items that are “should haves” (i.e., they should be on a prioritized Capacity
Needs list). This list is collapsed by those items with the greatest number of
votes. The second set of votes are conducted using the shortened list and are
those items that are “must haves” (i.e., they must be on a final prioritized list).
Creating a CAST-5 Action Plan
The development of an action plan for organizational capacity development is the final outcome of the CAST-5 process. The action plan can be used in multiple ways. The plan can be
packaged along with selected assessment proceedings in a final report that program staff
can refer to as they follow the implementation of capacity building proposals. It can also be
incorporated in Title V Block Grant applications and/or other program-specific related plans
as appropriate.
The CAST-5 action plan is the culmination of the entire set of discussions, assessments,
issues raised in the SWOT Analysis, and deliberations between CAST-5 team members. As a
result, it can be one of the most challenging components of the CAST-5 process to facilitate
and finalize.
There are numerous ways to develop and finalize the CAST-5 action plan. States may
choose to develop the action plan separate of or during the CAST-5 meeting. In other
cases, states may choose to develop a framework for the action plan during the CAST-5
meeting but assign staff or work groups to flesh out more detailed components at a later
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Section IV
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time. Regardless of how and when the action plan is developed, the facilitator should assure that the CAST-5 team specifies a process with timelines, and staff or work group assignments for creating and finalizing a detailed action plan.
Factors That Help Support the Development of an Action Plan:
•
An effective process for prioritizing the Capacity Needs that assures that specific
details about needs are not lost if lists are collapsed or needs grouped together.
•
A clearly written list of prioritized and specific Capacity Needs.
•
A clearly defined process for developing the action plan that identifies participant or workgroup roles and specifies a timeline for completion.
•
When action plans are developed separate of the CAST-5 meeting, clear mechanisms of communication between participants or workgroups as the action plan
is being developed and finalized.
•
Clear communication between state Title V program decision makers and any
administrators who need to be apprised of the CAST-5 process, outcomes, and
action plan.
•
Commitment and leadership by the state Title V program leader and staff to ensuring that the action plan is finalized and its goals and activities are advanced.
A sample worksheet that provides broad guidance on creating an action plan for organizational capacity development is in the Action Plan section of CAST-5. States may have other
action plan worksheets or mechanisms that are more familiar to state staff. Additional action planning resources are located in Appendix 11.
CAST-5© Planning Guide
Section V
Page 25
Section V: Assuring Momentum and Measuring Success
Facilitators play an important role in helping the CAST-5 team assure momentum, maintain
excitement and commitment to the process, and identify ways to measure success in addressing identified Capacity Needs. By incorporating this step throughout the stages of
CAST-5, facilitators help assure that some closure is placed on the CAST-5 process and that
participants know “where they are going.”
Tips for Assuring CAST-5 Momentum and Measuring Success:
•
Identify doable and reachable action plan activities. This can help the CAST-5
team achieve a sense of early “wins” and accomplishments that will help in
maintaining momentum.
•
Identify short-term (e.g., 6 months to 1 year) and long-term (e.g., 1 – 3 years)
activities in the CAST-5 action plan. Identifying short-term activities can also help
in achieving early “wins.”
•
Engage CAST-5 team members in identifying ways to measure whether they are
successful in implementing the action plan (i.e., “measures of success”).
•
Write the measures of success on newsprint and provide a summary to participants in a handout.
•
Identify predetermined intervals when the CAST-5 team will reconvene to assess
progress towards meeting the CAST-5 action plan and measures of success.
•
Make staff or work group assignments with realistic timelines for carrying out
the action plan steps.
Facilitators should also have participants complete a brief evaluation of CAST-5. This information can assist state Title V program decision makers and the facilitator in implementing
future CAST-5 efforts. A sample CAST-5 evaluation form is located in Appendix 12.
CAST-5© Planning Guide
Section V
Page 26
Conclusion
CAST-5 is a set of tools that engage state Title V program administrators, managers, staff
and others in identifying capacity needs and setting priorities related to the program’s desired functions and capacities. While the CAST-5 process is finite, the process of shifting a
state Title V program toward more effective functioning and ways of doing business may
take several years. As such, CAST-5 can become a tool state Title V program leaders periodically use to identify state needs and implement “continuous capacity improvements.”
A recent study examining how states have implemented CAST-5 indicates that the tool has
been used to achieve a range of planning and capacity assessment goals, some of which
are more formal than others. (See “Five Years of Experience with CAST-5,” available at
www.amchp.org/cast5.) For some states, engaging staff in the CAST-5 process and making
new or enhanced linkages between programs and staff is a sufficient and important outcome. Indeed, some states have used CAST-5 as an orientation tool for new and/or existing
MCH staff. On the other hand, many states have used CAST-5 to determine how to build
organizational capacity and ultimately effect change within the state Title V program.
Regardless of the CAST-5 goal, it is important to have at least one CAST-5 point person in
the program to serve as coordinator, as well as an internal or external facilitator to assist
the program through this ongoing process. Experience has shown that strong and effective
leadership from the state Title V program leader and staff involved in the process is equally
critical in order to ensure that the outcomes of the CAST-5 process are achieved and advanced.
CAST-5© Planning Guide
Acknowledgments
Page 27
Acknowledgments
Capacity Assessment for State Title V (CAST-5) is a collaborative initiative of the Association
of Maternal and Child Health Programs (AMCHP) and the Johns Hopkins Women’s and Children’s Health Policy Center (WCHPC), with support from the Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services. This document was originally published in 2002 as the CAST-5 Facilitators
Guide. This document updates the 2002 version to correspond to the Second Edition of
CAST-5 (2004).
CAST-5 and the CAST-5 Facilitators and Planning Guides were developed with the invaluable leadership, guidance and input of federal and state Title V program administrators and
other colleagues in the maternal and child health (MCH) community. Marjory Ruderman
and Holly Grason, of the WCHPC, authored CAST-5. Together with Frances Varela, formerly
of AMCHP, and Gillian Silver, formerly of WCHPC, they provided critical direction and input
to the development of the original Planning Guide. AMCHP and WCHPC would like to thank
the following colleagues for their guidance on the development of the Planning Guide and
their willingness to share state examples of CAST-5 resources: Donna Barber, Sally Fogerty,
Priscilla Guild, Catherine Hess, Joan Kennelly, Kay Leeper, Rita Schmidt, and Kayla Tinker .
About AMCHP
AMCHP is the national organization representing state public health leaders and other interested
individuals and organizations working to improve the health and well being of women, children,
youth and families, including those with special health care needs. AMCHP accomplishes its mission through the active participation of its members and vital partnerships with government agencies, families and advocates, health care purchasers and providers, academic and research professionals and others at the national, state and local levels.
About WCHPC
WCHPC was established in 1991 to address current policy issues found in national legislative initiatives and evolving health systems reforms impacting on the health of women, children, and adolescents. The mission of the Center – which operated during its first five years as the Child and Adolescent Health Policy Center – is to draw upon the science base of the university setting to conduct
and disseminate research to inform maternal and child health policies and programs, and the practice of maternal and child health nationally. The Center's work involves developing conceptual models and frameworks to guide its research and analytic projects, developing new methods and tools
for health system assessment and analysis, conducting evaluations of innovative programs, convening symposia and teaching forums, and publishing a series of policy research and technical resource briefs specifically designed to support activities in MCH practice and policy development.
The WCHPC is located at the Johns Hopkins Bloomberg School of Public Health, Department of
Population and Family Health Sciences.
CAST-5© Planning Guide
CAST-5© Planning Guide
Page 29
Appendix 1: Revision of CAST-5 Preliminary Edition
The Preliminary Edition of CAST-5 was first disseminated at the 2001 AMCHP Annual Meeting.
Although the Preliminary Edition had been pilot tested in three states before it was finalized,
the first two years of use in other states yielded a wealth of information about the content and
structure of the CAST-5 tools. Staff of the Women’s and Children’s Health Policy Center surveyed and interviewed Title V Directors and staff who had used CAST-5, in order to solicit their
suggestions for improvements. An ad hoc advisory group of Title V Directors and consultants
who had facilitated CAST-5 processes provided further guidance for revising the CAST-5 Tools.
The Second Edition of CAST-5 was pilot tested in Florida and Minnesota in 2003 and disseminated in early 2004. It subsequently became clear that major changes to the original CAST-5
Facilitators Guide were necessary in order to reflect the content and structure of the second
edition of CAST-5. The CAST-5 Planning Guide is the result.
The key difference between the Preliminary Edition and the Second Edition of CAST-5 resulted
from a major restructuring of the Capacity Needs Tool, which is used to identify specific organizational resources needed for optimal performance of the 10 MCH Essential Services. In the
Preliminary Edition, a Capacity Needs Tool was attached to each of the 10 MCH Essential Services. Feedback from states indicated that this format was burdensome and redundant. The
Second Edition of CAST-5 therefore contains a single Capacity Needs Tool that is completed
just once. This streamlined process saves time and significantly reduces the information management burden.
Additional changes in the CAST-5 Second Edition include an explicitly modular format, making
it easier to use the tools individually or in different combinations, and new guidance on using
CAST-5 with the Title V Needs Assessment and Performance Measures. All of these changes
and additions have been incorporated into the updated CAST-5 Planning Guide. Other new
materials were added as well, including:
•
•
•
•
Sample agendas from states that had used the Second Edition;
Facilitation tips and resources from states that had completed assessments;
Guidance on maintaining momentum for assessment follow up; and
Expanded discussions about planning for and structuring the assessment.
CAST-5© Planning Guide
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Appendix 2: CAST-5 Resource Colleagues
A cadre of Title V experts have been trained to assist states in using CAST-5. Some of these "CAST5 Resource Colleagues" are available for on-site facilitation of CAST-5 assessments, while others
are available only for consultation by phone or e-mail. Specific functions of the Resource Colleague,
including compensation when appropriate, are negotiated independently with each state.
Donna Barber, RN, MPH
3300 Killala Way
Tallahassee, FL 32309
Tel: 850-893-0767 or 850-212-8353
Fax:
E-mail: [email protected]
Willing to travel for on-site facilitation/consultation.
Will assist with entire assessment process.
Susan Burke, EdD
Consultants in Development
5647 W. Arrowhead Lakes Drive
Glendale, AZ 85308
Tel: 623-561-6566
Fax: 623-561-5318
E-mail: [email protected]
Willing to travel for on-site facilitation/consultation.
Will assist with entire assessment process.
Donalda Dodson, RN, MPH
Administrator, Office of Family Health
Department of Human Services
800 NE Oregon Street, Suite 850
Portland, OR 97232
Tel: 503-731-4398
Fax: 503-731-4083
E-mail: [email protected]
Willing to travel for on-site facilitation/consultation.
Will assist with introductory/orientation work and
strategic thinking/CAST-5 Core Questions.
Holly A. Grason, MA
Director
Women’s and Children’s Health Policy Center
Johns Hopkins Bloomberg School of Public Health
615 N. Wolfe Street
Baltimore, MD 21205
Tel: 410-502-5443
Fax: 410-502-5831
E-mail: [email protected]
Priscilla Guild, MSPH
Deputy Director for Administration
Cecil G. Sheps Center for Health Services Research
University of North Carolina - Chapel Hill
725 Airport Road – CB #7590
Chapel Hill, NC 27599-7590
Tel: 919-966-7117
Fax: 919-966-5764
E-mail: [email protected]
Willing to travel for on-site facilitation/consultation in
region 4, otherwise by phone/fax/e-mail.
Will assist with all assessment components except writing final report (but will assist with editing it).
Catherine A. Hess, MSW
Senior Program Director
National Academy for State Health Policy
1233 20th Street, NW Suite 303
Washington, DC 20036
Tel: 202-903-2783
Fax: 202-903-2790
E-mail: [email protected]
Willing to travel for on-site facilitation/consultation.
Will assist with entire assessment process.
William Hollinshead, MD, MPH
Medical Director
Division of Family Health
Rhode Island Department of Health
Three Capitol Hill, Room 302
Providence, RI 02908-5097
Tel: 401-222-1185
Fax: 401-222-1442
E-mail: [email protected]
CAST-5© Planning Guide
Appendix 2: CAST-5 Resource Colleagues
Millie Jones, MPH
Director
Bureau of Community Health Promotion
Wisconsin Division of Public Health
P. O. Box 2659
Madison, WI 53701-2659
Tel: 608-266-2684
Fax: 608-267-3824
E-mail: [email protected]
Joan Kennelly, MPH, PhD
Consultant
Chicago Department of Public Health
Research Assistant Professor
MCH Training Program, Division of Community
Health Sciences
University of Illinois School of Public Health
1603 West Taylor Street
Chicago, IL 60612
Tel: 312-996-5752
Fax: 312-996-3551
E-mail: [email protected] or [email protected]
Willing to travel for on-site facilitation/consultation.
Will assist with entire assessment process.
Lorraine Klerman, DrPH
Professor, The Heller School for Social Policy and
Management
Brandeis University
P.O. Box 9110, Mailstop 035
Waltham, MA 02454-9110
Tel: 781-736-3715
Fax: 781-736-3865
E-mail: [email protected]
Willing to travel for on-site facilitation/consultation.
Will assist with entire assessment process.
Kay Leeper, RNC, MSN
Community Health Consultant
Center for Disabilities and Development
University of Iowa Health Care
1407 Independence Avene, 4th Floor
Waterloo, IA 50703
Tel: 319-291-2661
Fax: 319-291-2659
E-mail: [email protected]
Willing to travel for on-site facilitation/consultation.
Will assist with entire assessment process.
Page 31
Molly McNulty, JD
Director
McNulty Consulting
57 Willard Avenue
Rochester, NY 14620
Tel: 585-244-5261
E-mail: [email protected]
Willing to travel for on-site facilitation/consultation.
Will assist with strategic thinking/ CAST-5 Core
Questions, action plan, and preparation of final report.
Kathryn Peppe, RN, MS
2845 Margate Road
Columbus, OH 43221
Tel: 614-486-9773
Fax: 614-486-0894
E-mail: [email protected]
Willing to travel for on-site facilitation/consultation.
Will assist with entire assessment process.
Adriana A. Pust, MSSA
Workforce Development and Training Administrator
Bureau of Environmental Health
Ohio Department of Health
PO Box 118
Columbus, OH 43216-0118
Tel: 614-466-3335
Fax: 614-644-9850
E-mail: [email protected]
Willing to travel for on-site facilitation/consultation.
Will assist with entire assessment process (except
writing final report – but will assist with editing).
Marjory Ruderman, MHS
Project Director
Women’s and Children’s Health Policy Center
Johns Hopkins Bloomberg School of Public Health
Home Office:
911 Elm Avenue
Takoma Park, MD 20912
Tel/fax: 301-891-2215
E-mail: [email protected]
CAST-5© Planning Guide
Appendix 2: CAST-5 Resource Colleagues
Rita Schmidt, MPH
Special Assistant
Community and Family Health
Washington State Department of Health
PO Box 47830
Olympia, WA 98504-7830
Tel: 360-236-3714 or 360-956-3131
Fax: 360-664-4500
E-mail: [email protected]
Willing to travel for on-site facilitation/consultation.
Will assist with entire assessment process.
Prefers small to medium-sized states.
Page 32
Frances Varela, RN, MSN, MALAS
Consultant
Family and Community Health
1616 Los Arboles, NW
Albuquerque, NM 87107
Tel: 505-343-1997
Fax: 505-342-1544
E-mail: [email protected]
Gillian B. Silver, MPH
Manager, Educational and Research Programs
Association of Schools of Public Health
1101 15th Street NW, Suite 910
Washington , DC 20005
T: 202-296-1099, ext. 132
F: 202-296-1252
Email: [email protected], [email protected]
Will assist with entire assessment process.
Susan Uttech, MS, CHES
Section Chief
Bureau of Community Health Promotion
Wisconsin Division of Public Health
P. O. Box 2659
Madison, WI 53701-2659
Tel: 608-267-3561
Fax: 608-267-3824
E-mail: [email protected]
Willing to travel for on-site facilitation or consultation.
Will assist with entire assessment process.
Karen VanLandeghem, MPH
Consultant
537 S. Mitchell
Arlington Heights, IL 60005
Tel/fax: 847-797-1824
E-mail: [email protected]
Willing to travel for on-site facilitation/consultation.
Will assist with entire assessment process.
CAST-5© Planning Guide
Page 33
Appendix 3: Facilitation Techniques and Tips
The following general group process facilitation techniques and tips are taken from:
Varela F and Chene R. Introduction to Group Facilitation Skills Course Outline, University of
New Mexico, 1999.
A. Seven Deadly Sins of Facilitation:
The facilitator:
•
Chooses which comments are worthy to be recorded on flip charts.
•
Interprets the words that are spoken and records the interpretation, instead
of recording what is said.
•
Permits the group to wander away from the stated objective for an extended
period of time and/or ignores agenda time lines.
•
Permits the ground rules to be broken without taking visible, corrective action.
•
Is perceived as losing neutrality and favoring one position over another.
•
Speaks emotionally charged words at a session attendee or permits a session attendee to speak emotionally charged words to another and does not
take visible corrective action.
•
Allows an atmosphere of distrust or disrespect to build between him/her and
the session attendees.
B. Brainstorming
Brainstorming is an idea-generating technique in which a group of people throw out their
ideas as they think of them, so that each has the opportunity to build on the ideas of others.
The discipline of brainstorming is maintained by four basic rules. However, the informality
of the process generates an atmosphere of freedom. The rules are:
1. No evaluation of ideas
2. Encourage wild ideas and “out of box” thinking
3. Hitchhike—build on the ideas of others
4. Strive for quantity
CAST-5© Planning Guide
Appendix 3: Facilitation Techniques and Tips
Page 34
How to brainstorm:
The facilitator presents the problem for which ideas are sought. This is most often posed in
the form of an open-ended question, for example, “What are some ways we can increase
accessibility of family planning services to working women in this community?” The wording of the question or problem should encourage specific, tangible ideas, not abstract ideas
or opinions. The facilitator makes sure that the members understand the issue or problem,
the objective of the brainstorming session, and the process to be followed.
There are three methods of brainstorming:
Free wheeling:
Group members call out their ideas spontaneously.
The scribe records the ideas as they are suggested.
Round-robin:
The facilitator asks each member, in turn, for an idea.
Members may pass on any round.
Ideas are recorded as in free wheeling.
Slip method, or all-on-the-wall:
The facilitator asks group members to write down their ideas on half sheets of paper, large post-it notes, or index cards. Facilitator asks members to write down one
idea per sheet or card as legibly as possible.
The ideas are collectged and put up on a wall for all to see.
The ideas are organized into categories by the group or the facilitator with the help
of the group.
CAST-5© Planning Guide
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Appendix 4: CAST-5 Implementation Options
CAST-5 is designed to be used flexibly to meet varying needs. It can be used in full, or individual components can be selected. The assessment can be carried out at the level of the governmental MCH system (including non-Title V partners), the level of the Title V program, or the individual program area
level. Each state will need to determine the best combination of approaches for its program, given staff
availability, competing demands on the program (e.g., whether or not the state legislature is in session,
whether the MCHB Block Grant 5-Year Needs Assessment is soon due), and so forth. Those designing
a CAST-5 process will want to consider the breadth of perspectives desired, the implications of various
options for eliciting information and ideas, the timeframe available and/or specific timing goals, as well
as other management and resource parameters.
Scope
Variations
Cons
• Best way to get the “big picture”
•
• Time consuming
• High level of Staff Commitment
Selected Subset(s)
of Essential Services
• More manageable organizational/
management burden
• May be a more efficient way of focusing
on an essential service/functional area
already deemed a priority
• May leave gaps in assessment
• May be difficult to determine which essential services to focus on without prior planning
• Helps to assure that the end result
includes concrete steps to address
identified problem areas
• Using only the process indicators in
conjunction with a detailed analysis of
strengths, weaknesses, opportunities,
and needs can provide a useful framework for thinking about current program function and desired program
directions
• Large commitment of time and personnel
• Provides a sense of the “big picture”
• Reduces redundancy
• Depending on scope, depth and timeframe, participants may desire a more
immediate sense of closure at each step
in the assessment process
• May provide more immediate sense of
next steps to take
• May be easier to manage in smaller
“chunks”
• If many essential services are assessed,
developing multiple action plans may be
prohibitively time consuming
• Generating multiple plans effectively bypasses important synthesizing steps in the
CAST-5 process that highlight overarching
themes, which may lead to disjointed action steps and unnecessary redundancy
All Tool Components
Depth
Pros
All Essential Services Simultaneously
Selected Tool Components
Output
One Action Plan
Separate Action
Plans
• Still need to make sure that an action plan
is developed to ensure productivity and
closure -- this may be easier if the capacity
needs tools are used
CAST-5© Planning Guide
Appendix 4: CAST-5 À La Carte
Page 36
Pros
Variations
Timeframe
Compressed
(e.g., retreat,
series of meetings)
Extended
(e.g., series of
meetings over
several months)
All MCH/CSHCN
Program Units
Participants
Selected Program Units
Program Management Only
Broad Staff Involvement
• Allows more time for richer discussions,
and involvement of more perspectives
• Fosters sense of team- and programbuilding
• More efficient overall than doing separately
if all units are planning to participate at
some point within the same timeframe
• Can be done more quickly/efficiently
• Can go through process on a specific issue
• Can be done regardless of rest of Title V
program’s ability to participate
• Keeps authorized decision makers highly
involved and informed, which may assure
an effective process and outcome
• Reduces complexity of task and streamlines discussions
• Could enhance quality of discussions and
assure a thorough capacity assessment
• CAST-5 process could serve as an educational or staff development strategy
Cons
• CAST-5 involves intensive discussions and
deliberations, and team members may
fatigue quickly
• “Burn out” could result in an overall negative experience as opposed to the desired
team- or program-building
• The group may risk not being able to complete the full process in the allotted time
period
• Participants may lose interest
• Program context could change in ways that
affect assessment results
• More difficult to schedule
• Discussions may be more lengthy and contentious
• May miss out on leveraging complementary
efforts that may be taking place concurrently in other program units
• May have less effective implementation of
action plan by staff
• More difficult to schedule
• Discussions may be more lengthy and contentious
• Staff may be reticent to express themselves
freely in presence of supervisors
• Potential for only “party-line” perspectives
Internal Program
Personnel Only
Including External Partners
• Simpler process
• Could help build support for and coordination with Title V Activities
• More difficult to schedule
• Discussions may be more lengthy and contentious
One Assessment
Team
• Increases consistency of results
• Increases facility using CAST-5 tools
• Allows for inclusion of a greater number of
staff members and perspectives
• Potentially greater “buy in” to carry out
action plan
• May increase the likelihood of “burnout”
(within government or from the
community)
Grouping
• Assures that momentum, collective knowledge of the process, and discussions are
not lost due to time away from the process
• May be necessary to achieve desired results at appropriate time for funding, political, program or other purposes
Small Workgroups
• More advance preparation needed
• Potentially more difficult to schedule meetings
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Appendix 5: Samples of State CAST-5 Agendas
Sample Agenda #1
Day One
8:30 a.m.
8:45 a.m.
9 a.m.
9:30 a.m.
Welcome and Introductions
The Assessment Process and Overview of CAST-5
The CAST-5 Core Questions
Assessment of Essential Service #5 (Leadership for Priority Setting, Planning,
and Policy Development)
11 a.m.
Workgroup Instructions followed by Break
11:15 a.m. Workgroup Breakout Sessions
Workgroup A: Essential Service # 1 Process Indicators and SWOT
Workgroup B: Essential Service #3 Process Indicators and SWOT
Workgroup C: Essential Service #4 Process Indicators and SWOT
12:45 p.m. Lunch and Workgroup Reports
2 p.m.
Workgroup Breakout Sessions
Workgroup D: Essential Service # 7 Process Indicators and SWOT
Workgroup E: Essential Service #8 Process Indicators and SWOT
3:30 p.m. Break
3:45 p.m. Workgroup Reports
4:15 p.m. Wrap Up of Day One
4:30 p.m. Adjourn
Day Two
9 a.m.
9:30 a.m.
11:00 a.m.
11:15 a.m.
12:30 p.m.
1:00 p.m.
3:15 p.m.
3:30 p.m.
4:00 p.m.
4:30 p.m.
4:45 p.m.
Charge for the Day and Review of Day One Results
Capacity Needs Tool
Break
Prioritizing Capacity Needs
Lunch
Small Group Work: Developing an Action Plan
Break
Small Group Reports
Wrap Up and Next Steps
Evaluation of Assessment Process
Adjourn
CAST-5© Planning Guide
Appendix 5: Samples of State CAST-5 Agendas
Page 38
Sample Agenda #2
Day One
8:30 – 9:15 a.m.
Welcome, Introductions and Review of Meeting Goals
9:15 – 10:00 a.m.
The CAST-5 Core Questions: Where do we want to go?
10:00 – 10:15 a.m. Break
10:15 – 12:00 p.m. Providing Leadership for Priority-setting, Planning and Policy Development
12:00 – 2:30 p.m.
Assessing the “Big MCH Picture”: Where do we need to be and what
do we have in place? (Working Lunch)
2:30 – 3:00 p.m.
Break
3:00 – 4:30 p.m.
Discussing Group Assessments and Identifying Key Themes
4:30 – 5:00 p.m.
Wrap-up and Review of Goals for the Next Day
Day Two
8:30 – 9:00 a.m.
Review of the Day’s Agenda
9:00 – 10:00 a.m.
What do we need to have in place? Assessing the State’s Data Capacity
10:00 – 10:15 a.m. Break
10:15 – 11:15 p.m. Discussion of Key Themes from the Capacity Assessment and Links to
Overall Assessment from the Previous Day
11:15 – 12:00 p.m. Prioritizing the State’s Capacity Needs
12:00 – 1:00 p.m.
Lunch
1:00 – 2:30 p.m.
Developing the Action Plan
2:30 – 2:45 p.m.
Break
2:45 – 4:00 p.m.
Discussion of Draft Action Plans
4:00 – 4:30 p.m.
Measuring Our Success: Measures and Next Steps
4:30 – 5:00 p.m.
Wrap-up and Adjourn
CAST-5© Planning Guide
Appendix 5: Samples of State CAST-5 Agendas
Page 39
Sample Agenda #3
Three phase process:
Phase I: Face-to-face meeting of key state health department representatives to complete
the CAST-5 Core Questions and Process Indicators Tools.
Phase II: Three small-group teams meet separately to complete the Capacity Needs Tool for
each of their assigned MCH Essential Services. [The Preliminary Edition of CAST-5 contained a separate Capacity Needs Tool for each Essential Service. The Second Edition contains only a single Capacity Needs Tool.]
Phase III: Approximately three months after the first meeting, state team representatives
reconvene to review the results of the Capacity Needs Assessment, prioritize capacity
needs, and develop an action plan for the state. The final action plan incorporates the top
2-3 prioritized capacity needs to address in the short-term and long-term.
Phase I (one-day meeting)
Objectives of the Meeting
As a result of this meeting, participants will:
1. Broadly articulate the state’s vision/goals for the MCH population
2. Identify overall priority health issues and desired population health outcomes,
based on the state’s Title V needs assessment
3. Identify political, economic and organizational environments for addressing priority health issues,
4. Complete an initial first-step assessment of desired-against-actual program results and activities.
8:30 a.m.
Welcome and Review Goals of CAST-5 Assessment Process
9:00 a.m.
CAST-5 Core Questions: Where Do We Want to Go?
10:30 a.m.
Break
10:45 a.m.
CAST-5 Process Indicators: Where Do We Need to Be to Get There and Where
Are We Now?
Group 1:
MCH Essential Service #1
Group 2:
MCH Essential Service #3
Group 3:
MCH Essential Service #5
12:30 p.m.
Working Lunch: Review of Process Indicators
1:30 p.m.
CAST-5 Process Indicators: Where Do We Need to Be to Get There and Where
Are We Now? (continued)
Group 1:
MCH Essential Service #2, (#9 if time allows)
CAST-5© Planning Guide
Appendix 5: Samples of State CAST-5 Agendas
Group 2:
MCH Essential Service #7, (#4 if time allows)
Group 3:
MCH Essential Service #8, (#6 if time allows)
3:00 p.m.
Break
3:15 p.m.
Review of Process Indicators
4:00 p.m.
Wrap-up and Summary of the Day’s Discussions and Key Themes
4:30 p.m.
Next Steps
5:00 p.m.
Adjourn
Page 40
Phase III (one-day meeting)
Objectives of the Meeting
As a result of this meeting, participants will:
1. Review and react to the CAST-5 capacity assessment results.
2. Prioritize short-term and long-term capacity needs.
3. Develop a realistic, time-based action plan for addressing the priority capacity
needs.
4. Create action plan “measures of success.”
5. Provide input to and finalize a mission statement for the South Dakota MCH program.
8:30 a.m.
9:15 a.m.
10:00 a.m.
10:45 a.m.
11:00 a.m.
12:00 p.m.
12:45 p.m.
2:15 p.m.
2:30 p.m.
4:00 p.m.
4:30 p.m.
5:00 p.m.
Where We Were, Where We Are Going and How We Are Going to Get There?
Reacting to the Summarized South Dakota Capacity Assessment
(Please closely review the summary prior to the meeting!)
Prioritizing Capacity Needs
Break
Reviewing Prioritized Capacity Needs and Beginning the Action Plan Development Process
Lunch
Creating an Action Plan to Meet Prioritized Capacity Needs
(three small group breakouts)
Break
Finalizing the Action Plan
(full group)
Measuring Our Success: Measures and Next Steps
Finalizing the South Dakota MCH Mission Statement
CAST-5 Evaluation/Adjourn
CAST-5© Planning Guide
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Appendix 6: CAST-5 Meeting Planning Checklist
Obtain meeting space.
Select a location convenient for CAST-5 participants.
Select size and type of room to comfortably accommodate participants.
Determine meeting room set-up that will be conducive to discussions.
Determine number of breakout rooms or spaces that will be needed.
Other:
Schedule any pre-meeting(s) and the group leader training.
Provide significant advanced notice of meeting logistics to participants.
Include information about the location (including directions and parking),
date, time of training, and a telephone number for messages.
Provide guidelines for appropriate clothing.
Include a contact name and telephone number for further information.
Other:
Arrange for meals and refreshments.
Inquire about special dietary needs.
Other:
Determine equipment needs.
Overhead projector
Flipchart(s)/Easel
Computer LCD
Podium
Microphone(s)
Other:
CAST-5© Planning Guide
Appendix 6: CAST-5 Meeting Planning Checklist
Bring meeting supplies.
Name tags and/or name tents
Extra copies of pertinent CAST-5 handouts and materials
Markers and masking tape
Flipcharts/newsprint
Other:
Distribute CAST-5 materials packet. Packet contents might include:
Agenda
Logistics
General timeline for completing the CAST-5 process
CAST-5 tools and forms (color-coded)
List of Ten MCH Essential Services
CAST-5 Instructions-in-Brief (located in the CAST-5 Manual)
CAST-5 Feedback Form (located in the CAST-5 Manual)
CAST-5 Evaluation
Other:
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Page 43
Appendix 7: Sample Group Leader Tip Sheet
(This CAST-5 Group Leader Tip Sheet was developed by Karen VanLandeghem, Health Policy/Program Consultant, for the South Dakota CAST-5 process.)
SOUTH DAKOTA CAST-5 PROCESS GROUP LEADERS’ TIP SHEET
GENERAL TIPS
• Designate a group note taker to take notes/complete forms for your group. Ask for a volunteer to
help record the group’s answers using the relevant tools for each component of the
CAST-5 process (see below). Completed tools and newsprint will be used to help summarize discussions. Group members may also wish to complete the forms provided in
their packets as you lead them in discussion. Use the newsprint to record the SWOT
Analysis for each Essential Service. You may also wish to use the newsprint to record
your answers to the Process Indicators and Capacity Needs questions as you lead the
group through discussions.
• Elicit open and interactive discussion with all members of your group. Discussion and the reflective process are a key benefit to using the CAST-5 tool. As a group leader, try to elicit as
much discussion as possible while moving the group through the tool in the allotted
time.
• Periodically remind the group of identified goals and/or the focus of the Essential Service that you are
working on. It’s easy to get bogged down in the “minutia” as you move through the tools.
To maintain the focus of discussions, you may need to periodically bring the group back
to goals identified in the Core Questions discussion and/or the focus of the overall Essential Service that you are discussing.
• Keep the group focused on the overall discussion. Keep your group from getting bogged down
in trying to interpret what individual discussion questions “mean”. Discussion questions
(provided for each Process Indicator) are merely for prompting discussion.
•
Refer your team back to the Title V needs assessment, as needed, in answering questions.
•
Consider the questions thinking across your MCH system but also factoring in individual programs.
•
Encourage your group members to “think outside the box”.
PART I: Completing the PROCESS INDICATORS Process
• Designate a note taker to summarize your discussions by completing the Summary Sheet, and recording comments and the essence of discussions.
• Quickly have the group read through the full list of Process Indicators before engaging in discussions.
This will help the group get the “big picture” before discussing each indicator.
CAST-5© Planning Guide
Appendix 7: Sample Group Leader Tip Sheet
Page 44
• For each Process Indicator, lead the group in discussing how adequately the Title V agency performs
the function detailed. Responses should reflect “where you want to/need to be” given the
strategic goals the full group articulated during the Core Questions discussion. Record
comments and discussion. You should be able to describe concrete examples of each
activity or output.
• Consider and include contributions from outside agencies in your discussions. Contributions from
other agencies, organizations, etc. in the MCH system may be noted for each indicator.
• Use the discussion questions to “jumpstart” the discussion as needed. The questions are not intended to be specific criteria or a standard.
• Always consider and record SWOTs. Make sure to record your “Strengths, Weaknesses, Opportunities, Threats, and Other Considerations” throughout the discussion of each Essential Service that your group discusses.
• Save time to summarize key themes.
• What do I do with the Process Indicators Summary Sheet? Meeting coordinators will make a
copy for use in summarizing the entire meeting. Keep your group’s copy so that you can
refer back to your answers when you complete the Capacity Needs Tool.
PART II: Completing the CAPACITY NEEDS TOOL
• Briefly re-cap and refer the group back to prior discussions. Since completion of the Capacity
Needs will occur at a later date, when reconvening your group to complete the Capacity
Needs take some time to refer back to the answers to the Core Questions and Process
Indicators (using your completed Process Indicator Summary sheet).
• Designate a note taker to summarize your discussions using the Capacity Needs Tool. Add to the
SWOT Analysis as necessary.
• Review each Capacity Need listed and discuss the extent to which your Title V program has or needs
each resource. Keep in mind that the resource must be adequate to optimally perform
your current and desired roles and activities. Check the box (“have” or “need”) which
corresponds most closely to your answer. The list of resources marked “need” will be
used later in the CAST-5 process, along with the information recorded in the SWOT.
• Record specific details about each Capacity Need if appropriate. For example, an organizational
relationship might be adequate for coordinating services but not for accessing and using data.
• For competencies, consider whether your Title V program houses or has access to adequate numbers
of personnel with the specified capabilities and expertise.
CAST-5© Planning Guide
Appendix 7: Sample Group Leader Tip Sheet
Page 45
WHAT HAPPENS NEXT?
• The South Dakota Team reconvenes to review and discuss the results of the Capacity
Needs Tool.
• The Team discusses key themes that came out of the process, discusses strategic issues
(e.g., mission, overarching program goals, barriers, opportunities, etc.) and program content related to prioritizing Capacity Needs.
• The Team prioritizes the Capacity Needs.
• The Team develops a Capacity Development Action Plan.
QUESTIONS ABOUT USING THE TOOLS?
For questions about using the tools, etc., feel free to contact:
(Insert contact name and phone number)
CAST-5© Planning Guide
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Appendix 8: Sample Meeting Ground Rules
Sample I: General Ground Rules (used in the South Dakota CAST-5 Process)
1.
2.
3.
4.
5.
6.
Think “outside the box”.
Think broadly across MCH systems but be concrete.
Consider outside agencies’ and organizations’ contributions.
Embrace differing opinions.
Aim towards building consensus.
“Park” issues that are important but not relevant for today’s meeting.
Sample II: General Ground Rules for the Group (used in the Missouri CAST-5 Process)
1. Need honest input from bureaus.
2. Discussion stays in the meeting room.
3. Be able to have different opinions.
4. Ability to challenge the discussions without anyone taking it personally.
5. Keep product internal.
6. Identify consensus issues (core questions especially).
7. If an issue is settled, don’t go back unless new information is presented.
8. No such thing as a “bad idea”.
9. Freedom to think outside the box (say what you think).
10. Discussion is issue oriented.
11. Each person does not take what is said personally (reinforces #4).
12. Designated “time-outs”, as needed.
13. Need to know when we are finished.
14. Communicate in a compassionate, caring way.
Sample III: General Ground Rules for the Facilitator (used in the Missouri CAST-5 Process)
1. Essential service element does not have to just relate to activities in your bureau. If you are aware of capacity anywhere in or outside the division, bring it forward.
2. Discovery of lack of capacity for particular elements is just as important as identifying adequate capacity. This is a building process.
3. Much, if not most, of the capacity for some elements may be outside of the division and that capacity should also be identified.
CAST-5© Planning Guide
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Appendix 9: Tips and Trigger Questions for
Facilitating the CAST-5 Tools
Specific instructions for each of the CAST-5 Tools are included in the CAST-5 Instructions
and Guidance document. Please refer to that document for further detailed information.
I.
Core Questions (i.e., the fundamental level of program functioning)
Tips:
1. Clarify the purpose of the Core Questions vis-à-vis the rest of the CAST-5 assessment process.
2. Reinforce with participants that the Core Questions provide a context for responses in the subsequent CAST-5 Tools.
3. Remind the CAST-5 team that the Core Questions enable the team to collectively answer, “Where do we want to go programmatically?”
4. Post the answers to the Core Questions and review the responses with participants.
5. Refer to the Core Questions throughout the CAST-5 process and particularly
before prioritizing the Capacity Needs.
Trigger Questions:
(Please refer to the actual Core Questions, as they are open-ended discussion
questions.)
1. Where does the state Title V program want to be in one year? In five years?
II.
Process Indicators (i.e., the state’s current and desired performance levels)
Tips:
1. Remind participants that the Process Indicators enable the team to collectively answer, “Where do we need to be to get there?” and “Where are we
now?”
2. Instruct the group to analyze the strengths, weaknesses, opportunities and
threats (SWOT) related to performance of each essential service and record
the specific issues on newsprint.
3. Post the SWOT Analysis and review the responses with participants.
4. “Park” any issues that are important but may not be directly relevant to the
assessment or conversation at hand.
CAST-5© Planning Guide
Appendix 9: Tips and Trigger Questions
Page 48
5. Make sure that the Process Indicators Summary Sheet is completed at the
end of each Essential Service assessment.
6. Determine who will be the repository for the summary sheets (e.g., facilitator,
group leaders, Title V staff person).
7. Provide a full set of the completed Process Indicators Summary Sheets to
each CAST-5 team member to use when discussing the Capacity Needs Tool.
8. Remind the CAST-5 team to not get too mired in debating response categories. CAST-5 questions are meant to stimulate discussion.
9. Allow work groups some flexibility in using the worksheets as long as the context of discussions is recorded in the SWOT Analysis. (For instance, some
work groups may wish to distinguish ratings for different components of their
programs.)
Trigger Questions:
1. Where do you need to be to reach your vision?
2. Where are you now?
3. Who are the state Title V program’s key partners? What are their contributions?
III.
Capacity Needs Tool (i.e., the program resources needed to function adequately)
Tips:
1. Remind the CAST-5 team that the Capacity Needs Tool enables the team to
collectively answer, “What do we need to have in place?”
2. Post the SWOT Analysis and review the responses with participants.
3. “Park” any issues that are important but may not be directly relevant to the
assessment or conversation at hand.
Trigger Questions:
1. What do you need to have in place to reach your vision/goals?
2. What are the current resources to meet the MCH Essential Service that you are
assessing?
3. What resources do you use that are outside of the health agency?
CAST-5© Planning Guide
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Appendix 10: Sample Group Process Tool
This form was developed by Kay Leeper, Community Health Consultant at the Iowa Center
for Disabilities and Development, for use in the Iowa CAST-5 process. Participants were
asked to use this form in reacting to work group reports of MCH Essential Service assessments. After each work group report, the facilitator led a discussion on the four key points
and wrote key themes on newsprint. This form helped participants remain focused on the
content of individual group reports.
Iowa CAST-5 Listening Guide
Report of the Essential Service Work Groups
As you listen to the presentations from each work group, please note the following:
Surprises AH HA!:
Points of Dispute:
Additions:
Themes:
CAST-5© Planning Guide
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Appendix 11: Prioritization Methods
Decision-Making Technique: Dot Voting
♦
Variation #1 steps:
1. Each person gets 3 to 5 dots. (For shorter lists and smaller groups, give more
dots. For longer lists and larger groups, give fewer dots.)
2. Have each person place a dot behind the ideas they think are most important—
one dot per option.
3. Facilitator tallies up the dots. The idea with the most dots is priority #1, the second greatest number is priority #2, and so on.
♦
Variation #2 steps:
1. Same as above.
2. Each person can place their dots in any combination. They can allocate all their
dots to one idea or any number of dots to any other combination of ideas.
3. Same as above.
♦
Variation #3 steps:
1. Each person gets 3-5 dots of one color which signify a positive vote and 3-5 dots of another
color which signify a negative vote.
2. Same as for Variation #1.
3. Facilitator tallies the dots for both the positive and negative ideas as in Variation #1.
Decision-Making Technique: Ranking
♦
Variation #1 steps:
1. Group decides how many choices they will allow: 3, 4, or 5. Each participant
goes up to the list and puts a 1 by their top choice, a 2 next to their second
choice, and a 3 next to their third choice.
2. Facilitator tallies the scores. The lowest score is the group’s highest priority, second lowest score is the second highest priority, and so on.
CAST-5© Planning Guide
Appendix 11: Prioritization Methods
♦
Page 51
Variation #2 steps:
This variation can be done by individuals or in groups. This variation is used when the
group is trying to determine the number of priorities and how important they are relative
to one another.
1. Group or individual has one hundred points. The individual or group decides how
many points to put next to which ideas. The group or individual can put any combination of points next to any number of ideas they wish.
2. Facilitator tallies up the point. The idea with the highest number of points is the
first priority, the second highest is the second priority, and so on.
The Consensus Decision-Making Process
♦
Definition:
Consensus is a decision-making process in which all group members have a chance to
influence, accept and support a decision. Because of the iterative process involved,
consensus decision making is not only a way to make decision, it is also a way that new
information and new ideas are developed in the process of making a decision.
♦
Procedure:
1. Proposal is introduced. In consensus, you only introduce one proposal at a time.
2. Proposal is discussed in depth. Areas of agreement and disagreement are systematically identified. It is useful to use two flip charts to keep a list of all agreements and disagreements so that everyone can see them. Place the agreements
on one flip chart and the disagreements on the other.
3. Reconcile the differences one at a time. Do straw polling to identify who has the
strongest concerns and what the concerns are. Ask that person what changes
need to be made for them to agree on this proposal. If the group gets stuck,
have two people representing different points of view caucus at the meeting or
between meetings to come up with a compromise. To reconcile differences,
have the group collect more data and/or brainstorm alternatives.
4. Call for consensus, using the levels of consensus format below. If there is still
disagreement, go back to step 3.
CAST-5© Planning Guide
Appendix 11: Prioritization Methods
Page 52
♦
Preconditions for Effective Consensus:
The goal of consensus decision making is to reach a decision in which no one feels excluded—one in which everyone feels at least partially represented. Consensus as a process works best when a group has legitimate power to act on their own behalf. The group
must also have equal access to information. Poor decisions or misunderstandings occur with poor information. Group members must be willing to listen and exercise mutuality. They must be committed to working a shared problem-solving framework. Group
members must be willing to be flexible and shift positions in light of new insights.
♦
Procedure:
To demonstrate levels of consensus, group members can show fingers to demonstrate
their level of consensus. 1 finger = yes, and so on:
1. I can say an unqualified “yes” to the decision. I am satisfied that the decision is
an expression of the wisdom of the group.
2. I find the decision perfectly acceptable.
3. I can live with the decision. I’m not especially enthusiastic about it.
4. I do not fully agree with the decision and need to register my view about it. However, I do not choose to block the decision. I am willing to support the decision,
because I trust the wisdom of the group.
5. I do not agree with the decision and feel the need to stand in the way of this decision being accepted.
6. I feel we have no clear sense of unity in the group. We need to do more work before consensus can be reached.
CAST-5© Planning Guide
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Appendix 12: Sample Action Plan Template
The CAST-5 Second Edition includes a sample worksheet for developing a capacity building
action plan. Many states have developed their own templates by modifying the one included in CAST-5 or using an entirely different process altogether. The following sample
was used in the Iowa CAST-5 process.
CAST 5 STRATEGIC PLAN
(NAME OF ORGANIZATION)
Mission:
Vision:
Structural Resources Strategic Action Plan
Structural Resources Priorities
Team members:
Result 1
Action Step
Responsible
Person(s)
Date Due
Resources
Needed
Action Step Outcome
Responsible
Person(s)
Date Due
Resources
Needed
Action Step Outcome
Responsible
Person(s)
Date Due
Resources
Needed
Action Step Outcome
Result 2
Action Step
Result 3:
Action Step
CAST-5© Planning Guide
Page 54
Appendix 13: Sample CAST-5 Evaluation Form
Please complete the following questions and return the completed evaluation form to the facilitator (or state Title V program decision maker). All responses will be kept confidential.
1.
Overall, what did you like most about the CAST-5 process?
2.
Overall, what did you like least about the CAST-5 process?
3.
Please name one thing that you would like more of, in terms of the CAST-5 process?
4.
Please name one thing that you would have liked less of, in terms of the CAST-5 process?
5.
How do you envision using or implementing the results of the CAST-5 process (i.e., the action plan)?
6.
Please list three program or other areas that you think will improve as a result of the CAST5 process:
7.
Please rate the overall facilitation skills of the CAST-5 facilitator:
†Outstanding
†Excellent
†Good
†Fair
†Poor
Comments:
8.
Please rate the facilitator’s skills in leading the CAST-5 team through the CAST-5 process:
†Outstanding
†Excellent
†Good
†Fair
†Poor
Comments:
9.
Other comments:
CAST-5© Planning Guide